When ob/gyns "go bare," dropping their malpractice coverage

As malpractice insurance rates continue to climb out of reach, some physicians are choosing to practice without coverage. So far, the practice, known as "going bare" or "self-insuring," has been adopted mainly among physicians in Florida.

In Miami-Dade County, for example, nearly 20% of its 6,460 active physicians don't have malpractice insurance coverage. Going bare is most common among high-risk specialties such as obstetrics and neurosurgery, reported The Wall Street Journal (1/28/04).

Because going without malpractice coverage puts the responsibility for legal fees and any judgments or settlements squarely in the lap of the physician in the event of a lawsuit, many are advised to shelter their assets in trusts or partnerships. Because Florida state law already protects certain assets, such as a home, from being claimed in a judgment, physicians are taking the risk of practicing medicine without coverage. Moreover, claiming bankruptcy in the event of a lawsuit can further protect other assets.

As a result, patients who successfully sue self-insured physicians could receive less money for their injuries than they would have received if the physician had coverage.

Most states do not require physicians to carry malpractice insurance, and the American Medical Association voted in December 2002 to leave the decision to carry sufficient coverage to the individual physician. However, most hospitals and managed-care organizations require physicians to have coverage—making it impractical for most to go bare.